Más allá del malestar: integración de terapia cognitivo-conductual y psicología positiva en personas que viven con VIH

HIV has become a chronic condition; however, emotional distress (depression, anxiety, mental stress, and stigma) remains frequent and may undermine antiretroviral therapy (ART) adherence and quality of life. Cognitive behavioral therapy (CBT) shows benefits in reducing symptoms and strengthening health-related behaviors, yet an exclusive deficit focus can limit the consolidation of sustainable psychological resources. Positive psychology (PP) contributes evidence-informed interventions focused on strengths, positive affect, and meaning, with potential effects on coping, social support, and psychoneuroimmunological pathways related to chronic stress. Objective: to critically synthesize the evidence and propose an integrative CBT–PP model for people living with HIV beyond symptom reduction. Review methodology: an integrative documentary review (2000–2025) of biomedical and psychological literature (PubMed/MEDLINE, Scopus, PsycINFO, and Google Scholar), prioritizing meta-analyses, controlled trials, and high-rigor reviews; findings were organized through thematic triangulation across three axes: clinical-behavioral (CBT), salutogenic (PP), and mechanistic (psychoneuroimmunology). Theoretical analysis: the integration combines CBT modules (psychoeducation, cognitive restructuring, behavioral activation, coping skills, and adherence support) with PP modules (gratitude, savoring, strengths, meaning/purpose, and compassion), articulated by cross-cutting mediators (self-efficacy, emotion regulation, social support, and reduced allostatic load) and person-centered outcomes (well-being, quality of life, and self-care). Conclusions: the model should be tested in routine care (task-sharing and telepsychology), using standardized adherence measures and mental health/well-being outcomes.